Application of oblique nerve coaptation in autologous nerve transplantation

BACKGROUND: Autologous nerve transplantation has become the gold standard for other nerve repair methods. But conventional epineurial sutures is prone to misaligned sutures, erroneous axonal growth, and unsatisfactory repair. Finding a new, more effective nerve coaptation method to improve the efficacy of peripheral nerve repair remains an urgent clinical challenge. In this study, the repair efficacies of oblique nerve coaptations for sciatic nerve injury at various angles were observed, providing a theoretical foundation for further clinical applications. METHODS: Sixty-four Sprague-Dawley rats were randomized into four groups of 16. The autologous nerve transplantation model was established by severing and rejoining in situ a 10-mm segment of the sciatic nerve trunk at the angle of 30° (group A), 45° (group B), 60° (group C), or 90° (group D). Sciatic function index (SFI) measurement, measurement of the recovery rate of the wet weight of the triceps surae, electrophysiological examination of nerves, histological examinations, and image analysis were carried out 12 weeks after surgery. RESULTS: The SFI, the recovery rate of the wet weight of the triceps surae, the electrophysiological function of nerves, histological examinations, and image analysis 12 weeks after surgery indicated that all indices of groups A and B were significantly better than those of groups C and D (P<0.05). There was no significant difference between groups A and B or between groups C and D (P>0.05), although group C exhibited a trend of better recovery than group D. CONCLUSIONS: Oblique nerve coaptation at 30–45° in autologous nerve transplantation may significantly enhance nerve regeneration.